<%@ page language="java" contentType="text/html; charset=UTF-8"
    pageEncoding="UTF-8"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<%@include file="/WEB-INF/pages/comm/header.jsp"%>
<title>华军医院-当日挂号</title>
<style type="text/css">
	.col-md-8{
		margin-top: 10px;
	}
	.col-md-3{
		margin-top: 15px;
	}
</style>
</head>
<body>
<div class="container">
	<div class="panel">
		<div class="panel-heading">
			<h2 class="text-center">当日挂号<span style="font-size: 14px;margin-left: 20px;color: red;cursor: pointer;">操作说明</span></h2>
		</div>
		<div class="panel-body">
			<form id="myForm" class="form-horizontal" method="post">
				<div class="form-group">
					<label for="brName" class="control-label col-md-3 text-right">患者姓名:</label>
					<div class="col-md-8">
						<input type="text" class="form-control" name="brName"/>
					</div>
				</div>
				<div class="form-group">
					<label for="sex" class="control-label col-md-3 text-right">患者性别:</label>
					<div class="col-md-8">
						<select class="form-control" name="brGender">
							<option value="-1">请选择...</option>
							<option value="0">男</option>
							<option value="1">女</option>
						</select>
					</div>
				</div>
				<div class="form-group">
					<label for="brBornDate" class="control-label col-md-3 text-right">出生日期:</label>
					<div class="col-md-8">
						<input type="text" class="form-control" name="brBornDate"/>
					</div>
				</div>
				<div class="form-group">
					<label for="rCard" class="control-label col-md-3 text-right">身份证号:</label>
					<div class="col-md-8">
						<input type="text" class="form-control" name="brCard"/>
					</div>
				</div>
				<div class="form-group">
					<label for="rType" class="control-label col-md-3 text-right">挂号种类:</label>
					<div class="col-md-8">
						<select id="select1" class="form-control" name="tId">
							<option value="-1">请选择...</option>
						</select>
					</div>
				</div>
				<div class="form-group">
					<label for="kName" class="control-label col-md-3 text-right">挂号科别:</label>
					<div class="col-md-8">
						<select id="select2" class="form-control" name="kId">
							<option value="-1">请选择...</option>
						</select>
					</div>
				</div>
				<div class="form-group">
					<label for="rMoney" class="control-label col-md-3 text-right">挂号费:</label>
					<div class="col-md-8">
						<input type="text" class="form-control" name="ghMoney"/>
					</div>
				</div>
				<div class="form-group">
					<label for="rDate" class="control-label col-md-3 text-right">挂号日期:</label>
					<div class="col-md-8">
						<input type="text" class="form-control" name="ghDate" readonly="readonly" value="${ghDate }"/>
					</div>
				</div>
				<div class="form-group">
					<label for="remark" class="control-label col-md-3 text-right">备注:</label>
					<div class="col-md-8">
						<input type="text" class="form-control" name="remark"/>
					</div>
				</div>
				</form>	
			</div>
			<div class="panel-footer">
				<div class="col-md-9 col-md-push-7">
					<button id="ok" type="button" class="btn btn-success"><i class="glyphicon glyphicon-ok"></i>确认挂号</button>&nbsp;&nbsp;&nbsp;&nbsp;
					<button id="cancel" type="button" class="btn btn-danger"><i class="glyphicon glyphicon-remove"></i>取消挂号</button>&nbsp;&nbsp;&nbsp;&nbsp;
					<button type="button" class="btn btn-primary" onclick="doPrint()"><i class="glyphicon glyphicon-print"></i>打印挂号单</button>
				</div>
			</div>
	</div>
</div>
<%@include file="/WEB-INF/pages/comm/footer.jsp"%>
</body>
</html>